Seventy-one individuals with opioid dependence undergoing ambulatory treatment participated in a personal interview assessing the importance of their opioid-use rituals, the severity of compulsivity and obsessionality in relation to their drug use, and the number of obsessive compulsive disorder (OCD) symptoms. The level of compulsivity and obsessionality in opioid dependence was comparable to that found in OCD and alcohol addiction. The importance of rituals was inversely related to the number of opioid lapses during rehabilitation treatment and positively correlated with the number of non-drug-related OCD symptoms. Based on established norms for OCD symptoms, we estimated that 11.4% of our sample would meet diagnostic criteria for OCD, a rate which is over 4 times higher than the rate of OCD in the general population.

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The study examines the relationship between experiencing depersonalization during traumatic events and subsequent psychiatric symptomatology. Participants were 75 Boston University undergraduate students who reported I86 traumatic events. In formation about their experiences of depersonalization during these events was obtained by the Depersonalization Questionnaire (DQ) a scale based primarily on the Dissociation Experience Scale (Bernstein and Putnam, 1986). Symptomatology was measured by the Symptom Checklist-90-Revised (Derogatis, 1977). As predicted the participants who experienced depersonalization during traumatic events were found to be sign8cantly lower than those who did not on 7 out of the 9 SCL-90-R subscales and the General Severity Index (GSI) scale. When the severity of trauma was statistically controlled for, the significant differences between the two groups held up on five of the nine subscales and the GSI scale. These differences remained as significant when statistically controlling for the lime that passed since the traumatic events. These findings suggest that, for this sample, depersonalization during traumatic events played a significant role in defending [hem fiom the fill impact of these events.

Studies addressing the treatment o f dually diagnosed clients report that the lack o f integrated mental health and substance abuse treatment and the lack o f appropriate housing and aftercare are major pitfalls to successful treatment. This paper reports on an effort to resolve these problems by inte grating residential and outpatient aftercare and treatment. A program has been created in which clients progress through different levels o f residential treatment, including independent living, while being follow ed by one outpa tient multidisciplinary team. Mental illness and substance abuse problems are treated simultaneously and with equal importance, with emphasis on long-term treatment and care. This treatment takes place within a residen tial community. Cases illustrating this model are presented.Recent studies addressing the group of clients with both mental illness and alcohol/substance abuse disorders, known by the term "dual diagnosis," agree that there are many barriers to successful treatment (Drake, Osher, & Wallach, 1991). This preliminary report describes a comprehensive and integrated treatment program designed for dually diagnosed clients that is located within one neighborhood in a community. The program has been created through the affiliation of two residential programs, an outpatient mental health and substance abuse clinic, an aftercare program, and a sober housing agency. These integrated services provide complete care from inpa This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.